Grumpy not-so-old men: Midlife, men, hormones

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Published 4:00 am, Monday, February 9, 2009

Humboldt County psychotherapist Jed Diamond, who has written several books on the phenomenon of "Irritable Male Syndrome" and "Male Menopause."

Humboldt County psychotherapist Jed Diamond, who has written several books on the phenomenon of "Irritable Male Syndrome" and "Male Menopause."

Photo: Maureen Moore, The Willits News

Grumpy not-so-old men: Midlife, men, hormones

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Could a man's midlife crisis be more than a state of mind, but be linked to his endocrine system instead?

Few men like to acknowledge, if they're even aware of it, that they - like women - suffer effects from the loss of hormones as they age. In men, the effects show up as everything from irritable mood swings and flagging sex drive to loss of muscle strength and male identity, or so says Northern California psychotherapist Jed Diamond.

It's hardly the stuff of a romantic Valentine's Day dinner conversation, but Diamond, a therapy Cupid of sorts, has several books and a new online support group to help men with their midlives. In the process, he just might improve their love lives.

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Diamond's most recent book, "The Irritable Male Syndrome: Managing the Four Key Causes of Aggression and Depression" (Rodale; 2004) was a follow-up to "Male Menopause" (Source Books; 1997; now out of print). It has been such a hit with the wives and partners of grumpy men that he has developed an online support system at Menalive.com.

Web traffic to his site has increased fourfold since October, when the economy soured. That's in part because men's stress levels are higher, Diamond said, and also because he appeared on CBS' "The Early Show" and subsequently on YouTube.

The therapist, who worked in Mill Valley and San Rafael for 25 years before moving to Willits (Mendocino County) in 1994, offers AliveGuide, a combination of online therapy sessions, a workshop and a workbook for clients to record their progress. From his remote Northern California office, he is educating men around the globe about the little-known, but apparently widely experienced, phenomenon. For $39, he said, AliveGuide is an inexpensive and flexible approach to treatment, available at any time of day or night.

For starters, there's a quiz to help men determine whether they suffer from the syndrome. In broaching the topic with grumpy people, would anyone be surprised by their reactions?

"The chief response with men is denial," Diamond said in a phone interview from his home. "They say, 'No, I'm not irritable!' to their wife at the dinner table, or, 'Of course I'm irritable! My wife makes me irritable. If she wouldn't do the annoying things, I wouldn't be irritable!' "

Midlife crisis, Diamond believes, is just one aspect of male menopause, or andropause, as it is medically known. Women go through hormonal changes that cause cessation of the menstrual period, resulting in the inability to reproduce. Men don't lose their reproductive abilities, but some experience a decrease in testosterone levels.

"We've taken a slice and assumed it was the whole picture," he said. "There are a number of changes that men go through: hormonal, physiological, interpersonal, sexual and spiritual. When you think of midlife crisis, you think of the psychological or social changes, like when men act in a way that focuses upon youth. We ignore the hormonal and physiological changes. With women, we think the opposite, emphasizing the physiological changes."

Diamond's "Male Menopause" research was conducted through his private Men Alive Institute and based on anecdotal evidence of symptoms offered by 1,000 people who participated in the study. He reported his own data and included information culled from studies occurring in other countries.

His research for "Irritable Male Syndrome" started with the recognition that irritability is a symptom of andropause and can cause problems all by itself. He conducted another study with 6,000 men. He also developed the quiz and put it on the Web site, where he said 60,000 people have taken it worldwide.

Midlife truth?

Scientists may question his work because it has not undergone peer review. However, Louann Brizendine, a neuropsychiatrist at UCSF, said that many of his theories are true, anecdotally, for men nationwide.

"The concept of a midlife crisis has been questioned, but nonetheless, there is a correlation between declining testosterone and age in men," said Brizendine, who specializes in men and women's hormones as they age. "For some men, the decline in testosterone affects them in mood, muscle strength and sexual function. There is good evidence that declining testosterone in some men can make their mood decline, and some men have increased moodiness and irritability."

Brizendine, author of the best-selling "The Female Brain" (Random House/Broadway, 2006), is working on a book due out in September called "The Male Brain."

"There are studies that are peer reviewed from the National Institute of Mental Health showing that giving back androgens like DHEA and testosterone for those men does improve the mood of men in midlife with declining testosterone levels," she said.

Men, she said, have been medically neglected.

"There's been no equivalent to the Women's Health Initiative for men in this country, in studying hormone-replacement therapy for men," she said, referring to the 15-year program begun in 1991 by the National Institutes for Health to examine causes of death, quality of life and disability in postmenopausal women.

Diamond was influenced in his research by his family history. He was 5 when his father, then 42, became irritable and withdrawn and tried to commit suicide. He survived, but the family was never the same. "Ever since," Diamond writes on his Web site, "I've been on a crusade to understand male depression."

When Diamond reached middle age, he became irritable and experienced stress in his marriage, but chalked it up to his wife's behavior as she went through menopause. It wasn't until he began recognizing symptoms that were parallel to hers that he considered the possibility that he was undergoing andropause.

Those symptoms include problems with erections and sexual desire, high levels of irritability and anger, feelings of restlessness, difficulty sleeping and weight gain, even with proper diet and exercise.

4 key causes

One is a decrease in testosterone. Men become angrier because they feel less "like themselves," Diamond said. He pointed to research on animals in Scotland that showed rams and reindeer bit the metal in their cages, as well as other animals, when their testosterone levels dipped. When levels were high, they danced and mated, he said.

In addition, stress, biochemical changes in the brain and changes in male identity and male roles in society cause irritability. They're conflicted, he said, because roles once unique to men, such as being a breadwinner for the family, have shifted as women have entered the workforce, either by choice or out of necessity.

"The real crux for men is feeling that there's no real role anymore that is unique to men," he said. "Men have a feeling that they're not necessary, that women can get along without them. The men that I work with and thousands of men in the culture question themselves: Am I worth anything? What is my role? Sometimes, that gets played out in insignificant ways, like, 'Should I open the door for a woman?' or 'Should I spend more time with the children or go out and earn more money?' "

So, women and other life partners of grumpy men, take note: It's not necessarily you causing your partner's mood swings, or the thoughts in his head. Blame it on hormones instead.

Are you suffering from irritable male syndrome?

If you answer yes to six or more of these questions, you may be suffering from irritable male syndrome.

Jed Diamond's tips for helping your grumpy not-so-old man

2) Recognize your own feelings and fears about the situation (such as "He doesn't love me anymore" or "He's lost interest in me").

3) Open the dialogue and listen. Say, "Talk to me. What are you worried about? What's going on?"

4) Take the quiz, answering as you think your male partner would, then approach him with the quiz and say, "I saw it online and took it. I'm probably way off on the answers; I scored a 67. Why don't you try it?" Often a man will take the quiz to prove his partner wrong and end up with a higher score (pointing to irritable male syndrome).

5) Walk and talk. Unlike women, many men find it easier to talk if they're not looking at their partner face-to-face. Side-by-side communication is a mode in which men are more comfortable.

6) Remind the man and yourself that you're both on the same side. Often you start feeling like adversaries. The problem is irritable male syndrome, not you.